Glomerulitis, health and medicine homework help

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ACUTE
GLOMERULONEPHRITIS (AGN)
BY
Dr Grace Irimu
Consultant Pediatrician & Nephrologist

ACUTE GLOMERULONEPHRITIS
• Glomerulonephritis refers to a variety of renal
diseases in which proliferation and inflammation
of the glomerulus is 20 to an immunological
mechanism
• Acute is of abrupt onset ass. with one of the
following:
heamaturia
protenuria
oliguria
volume overload
+/_ azotemia- inconsistent

Diseases with acute proliferative GN &
acute nephritic syndrome in children
• Post infectious GN—post streptococcal
AGN and other infections
• Henoch- Schönlein purpura
• Membranoproliferative GN
• IgA nephropathy
• Alport syndrome
• Infective endocarditis related GN
• Shunt nephritis

Eatiology of post infectious AGN
Bacterial
• Group A ß-haemolytic Streptococcus- commonest cause
• Strept pneumoniae
• Staph aureus- in shunt infections
• S. epidermidis- in subacute bacterial endocarditis
Viral
• Hepatitis
• CMV, EBV,Rubella
Parasitic
• Plasmodium malarie and falciparum
• Schistosma mansoni

Acute Post-streptococcal GN
• A few of group A ß-haemolytic Streptococcus
are nephritogenic
• AGN almost NEVER occurs with rheumatic fever
in the same patient
• May be pharyngitis related or pyoderma
• Attack rate in presence of nephritogenic strain is
15%. –causing asymptomatic AGN in
some(50%)1.
• Appro. 20% of school children are carries of
streptococcus therefore no prodromal illness
1 Am J Med 48:9, 1970

5

• It is a disease of school age children 515yrs. Uncommon under 3 yrs of age.
• Very rare to have recurrence therefore no
need of prophylaxis
• .

Pathogenesis
• Not fully understood
• Correlation between the disease and major
histocompatibility complex antigens-HLA-D or
HLA-DR
• In the susceptible persons it is thought that the
streptococcal antigen is deposited within the
glomeruli and sti...


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